Digital Mammography Does Not Improve Detection Rates

Does x-ray go digital or not? Cost-
effectiveness will decide on this
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The technology does, however, offer other benefits, including slightly lower radiation doses for patients, that may prompt its increasing use despite its much higher costs. Known as "full-field digital mammography," the high-tech equipment records images of the breast electronically instead of on X-ray film. The pictures are stored directly in a computer system, where they can be enhanced, magnified or shared.

Three large trials of the technology have been completed, with several thousand women receiving digital mammograms in each. No statistically significant differences in detection rates were observed between the x-ray and the new digital technology. The patients in each group experienced identical positioning and compression of the breast.

"The studies that have been done so far haven't provided a 'slam-dunk' for full-field digital mammography," says Robert Maliff, associate director of the Health Systems Group at ECRI, whose Technology Assessment Group published the report.

"Cost-effectiveness will ultimately determine whether full-field digital mammography technology is adopted, since hospitals must justify their purchase based on exam volume and patient population," the report says.

Digital mammography systems cost at least three times as much as film systems. In addition to reducing radiation, they can also facilitate the use of computer-aided detection systems and can be easily transmitted for second opinions, according to the report. The technology lends itself to operational improvements. Without films to process, handle, and store, radiology workflow becomes more efficient, says Maliff.

"Many health care professionals predict that screen-film mammography will eventually be replaced by full-field digital mammography once it is proven that the image quality and diagnostic accuracy of both technologies are at least equivalent," says the ECRI report.

MEDICA.de; Source: Center for the Advancement of Health